Eternally PC

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

ETERNALLY PC

Practice address

104 Forrest Ave Apt 3
Narberth, PA 19072-2215

Phone

(856) 304-0337

NPI assigned

Mar 29, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matti Perilstein

Title

Ceo

Phone

(856) 304-0337

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1750968293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FORREST AVE APT 3",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190722215",
            "telephone_number": "856-304-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FORREST AVE APT 3",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190722215",
            "telephone_number": "856-304-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETERNALLY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "PERILSTEIN",
        "authorized_official_first_name": "MATTI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-304-0337"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Narberth, PA
• Health Educator in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.